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埃尔梅莱吉局部肌肉转位技术用于修复上下唇大型缺损功能的长期评估。

Long-term evaluation of Elmelegy's technique of local muscle transposition for the functional restoration of large upper or lower lip defects.

作者信息

Elmelegy Nader G

机构信息

Tanta University, Tanta, Egypt.

出版信息

Maxillofac Plast Reconstr Surg. 2024 Dec 18;46(1):41. doi: 10.1186/s40902-024-00450-9.

Abstract

BACKGROUND

Although more than 200 techniques have been reported for the reconstruction of the upper and lower lip defects since 1000 BC, none of them is ideal. Local flaps may result in extra skin incisions and in some cases, the surgeon may be confronted with the lack of sufficient tissues for the reconstruction of large defects. Several techniques have been described for near-total lip reconstruction. The two major available techniques are local flap reconstruction (Bernard-von Burrow-Webster technique) and free micro-vascular tissue transfer. In this study, we are going to evaluate the functional results of using local muscles transposition-assisted dermal fat flap and muco-buccal flap in the treatment of large upper or lower lip defects.

MATERIALS AND METHODS

This study was carried out on 128 patients, who presented to us with malignant tumors affecting the lips.

RESULTS

Lip defect sizes ranged from 4 to 6 cm in diameter. No flap failure was seen and desirable function and accepted esthetic results were obtained. The flap survival was 100%, and healing was eventful in all cases. No cases of microstomia were reported.

CONCLUSION

The use of local muscle transposition-assisted dermal fat flap and muco-buccal flap technique, showed excellent results in regaining oral competence and lip mobility, and as much as possible, increased the aesthetic outcome.

LEVEL OF EVIDENCE

IV therapeutic study.

摘要

背景

尽管自公元前1000年以来已报道了200多种上下唇缺损重建技术,但均不理想。局部皮瓣可能会导致额外的皮肤切口,在某些情况下,外科医生可能会面临缺乏足够组织来重建大面积缺损的问题。已经描述了几种近乎全唇重建的技术。两种主要的可用技术是局部皮瓣重建(伯纳德 - 冯·布罗 - 韦伯斯特技术)和游离微血管组织移植。在本研究中,我们将评估使用局部肌肉转位辅助真皮脂肪瓣和黏膜 - 颊瓣治疗大面积上唇或下唇缺损的功能结果。

材料与方法

本研究对128例因唇部恶性肿瘤前来就诊的患者进行。

结果

唇缺损直径范围为4至6厘米。未观察到皮瓣失败,获得了理想的功能和可接受的美学效果。皮瓣存活率为100%,所有病例愈合顺利。未报告小口畸形病例。

结论

使用局部肌肉转位辅助真皮脂肪瓣和黏膜 - 颊瓣技术,在恢复口腔功能和唇部活动度方面显示出优异的效果,并尽可能提高了美学效果。

证据水平

IV级治疗性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b8e/11655743/5d89e8379c0d/40902_2024_450_Fig1_HTML.jpg

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